Expanded QI program issues first report

Two in five residents are prescribed nine or more medications, one in five is using an antipsychotic and almost a third had fall in the period covered by the latest and expanded quality indicator report.

The July-September 2021 quality indicator report also found that a quarter of residents were physically restrained, almost on in 10 experienced unplanned weight loss and one in 20 had a pressure injury,

This report on the National Aged Care Mandatory Quality Indicator Program is the first to include new quality indicators medication management and falls and major injury. The program, which became mandatory in July 2019, now counts the number of care recipients meeting or not meeting the QI criteria rather than the number of occurrences.

The report, released on 2 March, includes data from 2,410 residential aged care services, representing 89 per cent of eligible services. However, not all care recipients are counted in each QI measurement due to various reasons, such as not consenting, being absent or receiving end-of-life care.

The report found that 41 per cent of residents were prescribed nine or more medications at the collection date in the quarter – the trigger for the polypharmacy indicator – while 21.6 per cent used an antipsychotic during the seven-day assessment period in the quarter.

The highest rate of polypharmacy was recorded in Western Australia (48 per cent), which also topped antipsychotic use (25.7 per cent) and followed closely by Victoria (25 per cent). The Northern Territory had the lowest rate of polypharmacy (25.3 per cent) and antipsychotic use (15.3 per cent).

Polypharmacy was more prevalent among metropolitan and regional residents (41.1 per cent) than those in rural and remote facilities (40.6 per cent). But antipsychotic use was more common among rural and remote residents (23.8 per cent) than their metropolitan and regional counterparts (21 per cent).

Almost one in three residents had a fall

In the July-September quarter, 31.9 per cent of residents recorded a fall and 2.1 per cent had a fall that resulted in major injury, such as bone fractures, joint dislocations, closed head injuries with altered consciousness or subdural haematoma.

The highest rate of falls was recorded in South Australia (35.8 per cent) and Western Australia (35.4 per cent) while Queensland had the highest proportion of falls resulting in a major injury (2.5 per cent). The NT recorded the lowest on both measures –19.2 per cent and 0.9 per cent respectively.

The rate of total falls was consistent across metropolitan, regional, rural and remote residents, but a major injury was higher among metro and regional residents (2.2 per cent) than their rural and remote counterparts (2 per cent).

Other key findings

Eslewhere the report shows that in the July-September quarter:

• 23 per cent of residents were physically restrained, which refers to any practice that restricts freedom of movement of care, such as physical, mechanical or environmental restraint and seclusion
• 8.4 per cent of residents experienced significant unplanned weight loss, which is a loss of 5 per cent or more than the previous quarter
• 9.5 per cent of residents experienced consecutive unplanned weight loss, which refers to unplanned weight loss every month in the quarter. In the July-September quarter:
• 5.9 per cent of residents had one or more pressure injuries, which refers to a localised injury to the skin or underlying tissue usually over a bony prominence, as a result of pressure or shear.

Access the report: Residential Aged Care Quality Indicators — July to September 2021

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